替格瑞洛治疗急性冠状动脉综合征患者的临床研究  

Clinical trial of ticagrelor in the treatment of patients with acute coronary syndrome

作　　者：张海龙[1] ZHANG Hai - long(Department of Cardiac Surgery and Vascular Surgery, Central Hospital of Shengli Oilfield , Dongying 257034, Shandong Province, Chin)

机构地区：[1]胜利油田中心医院心脏外科&血管外科,山东东营257034

出　　处：《中国临床药理学杂志》2018年第6期611-614,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(81100073)

摘　　要：目的观察长期服用替格瑞洛对急性冠状动脉综合征患者的临床疗效及其对肌钙蛋白T(cTnT)、脑钠素(BNP)、C-反应蛋白(CRP)和D-二聚体(D-D)水平的影响。方法将84例急性冠状动脉综合征患者随机分为对照组42例和试验组42例。2组均给予常规治疗及对症治疗,术前服用阿司匹林150mg联合氯吡格雷300 mg,口服,每日1次,持续用药7 d,进行经皮冠状动脉介入(PCI)术。对照组术后服用阿司匹林100 mg,每日1次,连续服用6个月。试验组术后服用阿司匹林100 mg+替格瑞洛90 mg,每日1次,连续服用6个月。比较2组患者的临床疗效和急性心肌梗死发作次数、发作持续时、ST段下移水平、cTnT、BNP、CRP、D-D水平及药物不良反应发生情况。结果治疗后,对照组和试验组临床总有效率分别为78.57%(33例/42例)和95.24%(40例/42例),差异有统计学意义(P<0.05)。对照组和试验组治疗后急性心肌梗死发作次数分别为(4.52±0.55)和(2.02±0.27)次/周,发作持续时间分别为每次(4.14±0.43)和(2.76±0.31)min,ST段下移水平1.25±0.17和0.63±0.07,差异均有统计学意义(均P<0.05)。治疗后,对照组血清cTnT、BNP、CRP、D-D水平分别为(1.54±0.18)ng·mL^(-1),(63.52±6.73)ng·mL^(-1),(8.94±0.94)mg·mL^(-1)和(133.53±15.73)ng·mL^(-1),试验组分别为(0.25±0.03)ng·mL^(-1),(28.43±3.02)ng·mL^(-1),(4.57±0.55)mg·mL^(-1)和(59.54±5.74)ng·mL^(-1),差异均有统计学意义(均P<0.05)。对照组出现头痛2例,腹泻2例,恶心呕吐1例,眩晕2例,药物不良反应发生率为16.67%(7例/42例);试验组出现胃肠道出血1例,血肌酸酐轻度上升1例,眩晕1例,药物不良反应发生率为7.14%(3例/42例),2组差异无统计学意义(P>0.05)。结论长期服用替格瑞洛治疗急性冠状动脉综合征患者的临床疗效显著,安全性高。Objective To investigate the clinical effect of long - term use of ticagrelor, and its effect on the levels of cardiac troponin T （cTnT）, brain natriuretic peptide （BNP）, C reactive protein （CRP）, D- diraer （D- D） in patients with acute coronary syndrome. Methods Eighty -four patients with acute coronary syndrome were randomly divided into control group （42 cases） and treatment group （42 cases）. Patients in two groups were given conventional treatment and symptomatic treatment. Patients were orally given aspirin 150 mg and clopidogrel 300 mg, 1 time a day for 7 d, followed by percutaneous coronary intervention （PCI）. After PCI surgery, patients in control group were given aspirin 100 mg, 1 time a day, for 6 months. Patients in treatment group were given aspirin 100 mg ＋ ticagrelor 90 mg, 1 time a day, for 6 months. The clinical efficacy, acute heart attacks, duration of time, levels of ST segment depression, serum cTnT, BNP, CRP, D - D and adverse drug reactions were compared in two groups. Results After treatment, total effective rates in control group and treatment group were 78.57% （ 33 cases/42 cases ） and 95.24% （ 40 cases/42 cases ） , with significant difference （ P 〈 0. 05 ）. The acute heart attacks in control and treatment groups were （4. 52 ± 0. 55 ） and （2.02 ± 0. 27 ） time/ week. The duration of attacks were （4. 14 ±0. 43） and （2.76 ±0. 31 ） min/time . The levels of ST segment depression were 1.25 ±0. 17 and 0.63±0.07. There were significant difference between the two groups （P 〈0. 05 ）. After treatment, the levels of cTnT, CRP, BNP and D - D in control group were （1.54 ± 0.18） ng·mL-1, （63.52 ±6. 73） ng·mL-l , （8.94 ±0. 94） mg·mL-1 and （ 133.53 ± 15.73） ng·mL-1 , had significant difference with those in treatment group, which were （0. 25 ± 0. 03） ng·mL-1, （28.43 ± 3.02） ng· mL-1, （4. 57 ± 0. 55 ） mg· mL- 1, （59.54 ± 5.74） ng· mL- 1 （ p 〈0. 05 ）. The adverse drug reactions in c

关 键 词：替格瑞洛 急性冠状动脉综合征 经皮冠状动脉介入术 肌钙蛋白T 脑钠素 

分 类 号：R972[医药卫生—药品]